The properties of cyproheptadine as an anti-spastic agent have been reported since 1980. In this study we sought to investigate whether gait function, as specified by stride length, cadence, heart rate, and also by questionnaire, correlated with cyproheptadine medication during a double-blind matched-placebo cross-over trial, undertaken on a group of 16 hemiplegic spastic patients aged 4-18 years. We found that neither qualitative nor quantitative analyses suggested any systematic change in gait parameters dependent on cyproheptadine medication. We conclude that our study on 16 patients showed no statistical evidence of improvement in spasticity due to the action of cyproheptadine. An effect was, however, found in the case of mean patient heart rate, which was 10% higher (P<0.003) at the end of the cyproheptadine medication period. Copyright 1998 Elsevier Science B.V.